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Individual

DR. MICHAEL EUGENE BOBLIT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4422 W LOCUST ST, DAVENPORT, IA 52804-3028
(563) 386-2163
Mailing address
4422 W LOCUST ST, DAVENPORT, IA 52804-3028
(563) 386-2163

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6791
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6791
IOWA DENTAL LICENSE
IA
Enumeration date
09/04/2006
Last updated
07/08/2007
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